Allergy Asthma Immunol Res.  2011 Jan;3(1):27-33. 10.4168/aair.2011.3.1.27.

Changes in the Prevalence of Childhood Asthma in Seoul from 1995 to 2008 and Its Risk Factors

• Kwon JW
• Kim BJ
• Song Y
• Seo JH
• Kim TH
• Yu J
• Kim HB
• Lee SY
• Kim WK
• Kim KW
• Ji HM
• Kim KE
• Kim H
• Hong SJ

• KMID: 2260374
• DOI: http://doi.org/10.4168/aair.2011.3.1.27

Abstract

PURPOSE
To investigate the prevalence of asthma and determine its risk factors in elementary school students in Seoul.
METHODS
A modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was used to survey 4,731 elementary school students from five areas in Seoul between April and October, 2008.
RESULTS
In elementary school children, the lifetime and recent 12-month prevalence of wheezing were 11.7% and 5.6%, respectively. The lifetime prevalence of asthma diagnosis was 7.9%, and the recent 12-month prevalence of asthma treatment was 2.7%. Male sex (adjusted odds ratio [aOR], 1.90; 95% confidence interval [CI], 1.36-2.66), history of atopic dermatitis (AD) (aOR, 2.76; 95% CI, 1.98-3.84), history of allergic rhinitis (AR) (aOR, 3.71; 95% CI, 2.61-5.26), history of bronchiolitis before 2 years of age (aOR, 2.06; 95% CI, 1.39-3.07), use of antibiotics during infancy for >3 days (aOR, 1.88; 95% CI, 1.35-2.62), parental history of asthma (aOR, 2.83; 95% CI, 1.52-5.27), exposure to household molds during infancy (aOR, 1.84; 95% CI, 1.18-2.89), and the development or aggravation of asthma symptoms within 6 months after moving to a new house (aOR, 11.76; 95% CI, 5.35-25.86) were the independent risk factors for wheezing within 12 months.
CONCLUSIONS
The prevalence of wheezing and asthma in elementary school students in 2008 was similar to that in the past decade. Male sex, history of AD, history of AR, history of bronchiolitis before 2 years of age, parental asthma, use of antibiotics during infancy, exposure to molds in the house during infancy, and development or aggravation of asthma symptoms within 6 months after moving to a new house, could be risk factors for wheezing within 12 months.

Keyword

Asthma; prevalence; risk factor; childhood

MeSH Terms

Anti-Bacterial Agents
Asthma
Bronchiolitis
Child
Dermatitis, Atopic
Family Characteristics
Fungi
Humans
Hypersensitivity
Male
Odds Ratio
Parents
Prevalence
Respiratory Sounds
Rhinitis
Rhinitis, Allergic, Perennial
Risk Factors
Surveys and Questionnaires
Anti-Bacterial Agents

Figure

• 

  Figure Prevalence of wheezing according to age and gender during the last 12 months before the survey. *P value <0.05 in comparison between males and females.

Reference

1. Panettieri RA Jr, Covar R, Grant E, Hillyer EV, Bacharier L. Natural history of asthma: persistence versus progression-does the beginning predict the end? J Allergy Clin Immunol. 2008. 121:607–613.

2. Eder W, Ege MJ, von Mutius E. The asthma epidemic. N Engl J Med. 2006. 355:2226–2235.

3. Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, Williams H. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006. 368:733–743.

4. Hong SJ, Ahn KM, Lee SY, Kim KE. The prevalences of asthma and allergic diseases in Korean children. Korean J Pediatr. 2008. 51:343–350.

5. Lee SI. Prevalence of childhood asthma in Korea: international study of asthma and allergies in childhood. Allergy Asthma Immunol Res. 2010. 2:61–64.

6. Hong SJ. Epidemiology of childhood asthma and allergic diseases. Pediatr Allergy Respir Dis. 2007. 17:Suppl 1. S55–S66.

7. Arruda LK, Solé D, Baena-Cagnani CE, Naspitz CK. Risk factors for asthma and atopy. Curr Opin Allergy Clin Immunol. 2005. 5:153–159.

8. Pattemore PK, Asher MI, Harrison AC, Mitchell EA, Rea HH, Stewart AW. The interrelationship among bronchial hyperresponsiveness, the diagnosis of asthma, and asthma symptoms. Am Rev Respir Dis. 1990. 142:549–554.

9. Dales RE, Ernst P, Hanley JA, Battista RN, Becklake MR. Prediction of airway reactivity from responses to a standardized respiratory symptom questionnaire. Am Rev Respir Dis. 1987. 135:817–821.

10. Hong SJ, Kim SW, Oh JW, Rah YH, Ahn YM, Kim KE, Koh YY, Lee SI. The validity of the ISAAC written questionnaire and the ISAAC video questionnaire (AVQ 3.0) for predicting asthma associated with bronchial hyperreactivity in a group of 13-14 year old Korean schoolchildren. J Korean Med Sci. 2003. 18:48–52.

11. Lai CK, Chan JK, Chan A, Wong G, Ho A, Choy D, Lau J, Leung R. Comparison of the ISAAC video questionnaire (AVQ3.0) with the ISAAC written questionnaire for estimating asthma associated with bronchial hyperreactivity. Clin Exp Allergy. 1997. 27:540–545.

12. Moorman JE, Rudd RA, Johnson CA, King M, Minor P, Bailey C, Scalia MR, Akinbami LJ. National surveillance for asthma--United States, 1980-2004. MMWR Surveill Summ. 2007. 56:1–54.

13. Anderson HR, Pottier AC, Strachan DP. Asthma from birth to age 23: incidence and relation to prior and concurrent atopic disease. Thorax. 1992. 47:537–542.

14. Becklake MR, Kauffmann F. Gender differences in airway behaviour over the human life span. Thorax. 1999. 54:1119–1138.

15. de Marco R, Locatelli F, Sunyer J, Burney P. Differences in incidence of reported asthma related to age in men and women. A retrospective analysis of the data of the European Respiratory Health Survey. Am J Respir Crit Care Med. 2000. 162:68–74.

16. Luyt DK, Burton PR, Simpson H. Epidemiological study of wheeze, doctor diagnosed asthma, and cough in preschool children in Leicestershire. BMJ. 1993. 306:1386–1390.

17. Venn A, Lewis S, Cooper M, Hill J, Britton J. Questionnaire study of effect of sex and age on the prevalence of wheeze and asthma in adolescence. BMJ. 1998. 316:1945–1946.

18. Peat JK, Salome CM, Woolcock AJ. Factors associated with bronchial hyperresponsiveness in Australian adults and children. Eur Respir J. 1992. 5:921–929.

19. Le Souéf PN, Sears MR, Sherrill D. The effect of size and age of subject on airway responsiveness in children. Am J Respir Crit Care Med. 1995. 152:576–579.

20. Alfvén T, Braun-Fahrländer C, Brunekreef B, von Mutius E, Riedler J, Scheynius A, van Hage M, Wickman M, Benz MR, Budde J, Michels KB, Schram D, Ublagger E, Waser M, Pershagen G. Allergic diseases and atopic sensitization in children related to farming and anthroposophic lifestyle--the PARSIFAL study. Allergy. 2006. 61:414–421.

21. Kitch BT, Chew G, Burge HA, Muilenberg ML, Weiss ST, Platts-Mills TA, O'Connor G, Gold DR. Socioeconomic predictors of high allergen levels in homes in the greater Boston area. Environ Health Perspect. 2000. 108:301–307.

22. Stern DA, Morgan WJ, Halonen M, Wright AL, Martinez FD. Wheezing and bronchial hyper-responsiveness in early childhood as predictors of newly diagnosed asthma in early adulthood: a longitudinal birth-cohort study. Lancet. 2008. 372:1058–1064.

23. Castro-Rodríguez JA, Holberg CJ, Wright AL, Martinez FD. A clinical index to define risk of asthma in young children with recurrent wheezing. Am J Respir Crit Care Med. 2000. 162:1403–1406.

24. Guilbert TW, Morgan WJ, Zeiger RS, Bacharier LB, Boehmer SJ, Krawiec M, Larsen G, Lemanske RF, Liu A, Mauger DT, Sorkness C, Szefler SJ, Strunk RC, Taussig LM, Martinez FD. Atopic characteristics of children with recurrent wheezing at high risk for the development of childhood asthma. J Allergy Clin Immunol. 2004. 114:1282–1287.

25. Sigurs N, Bjarnason R, Sigurbergsson F, Kjellman B. Respiratory syncytial virus bronchiolitis in infancy is an important risk factor for asthma and allergy at age 7. Am J Respir Crit Care Med. 2000. 161:1501–1507.

26. Singh AM, Moore PE, Gern JE, Lemanske RF Jr, Hartert TV. Bronchiolitis to asthma: a review and call for studies of gene-virus interactions in asthma causation. Am J Respir Crit Care Med. 2007. 175:108–119.

27. Foliaki S, Pearce N, Björkstén B, Mallol J, Montefort S, von Mutius E. Antibiotic use in infancy and symptoms of asthma, rhinoconjunctivitis, and eczema in children 6 and 7 years old: International Study of Asthma and Allergies in Childhood Phase III. J Allergy Clin Immunol. 2009. 124:982–989.

28. Marra F, Lynd L, Coombes M, Richardson K, Legal M, Fitzgerald JM, Marra CA. Does antibiotic exposure during infancy lead to development of asthma?: a systematic review and metaanalysis. Chest. 2006. 129:610–618.

29. Ahn KM, Lee MS, Hong SJ, Lim DH, Ahn YM, Lee HR, Lee MI, Lee MH, Shin YK, Kim KE. Fever, use of antibiotics, and acute gastroenteritis during infancy as risk factors for the development of asthma in Korean school-age children. J Asthma. 2005. 42:745–750.

30. Gilliland FD, Berhane K, Li YF, Rappaport EB, Peters JM. Effects of early onset asthma and in utero exposure to maternal smoking on childhood lung function. Am J Respir Crit Care Med. 2003. 167:917–924.

31. DiFranza JR, Aligne CA, Weitzman M. Prenatal and postnatal environmental tobacco smoke exposure and children's health. Pediatrics. 2004. 113:1007–1015.

32. Redlich CA, Sparer J, Cullen MR. Sick-building syndrome. Lancet. 1997. 349:1013–1016.

33. Fisk WJ, Lei-Gomez Q, Mendell MJ. Meta-analyses of the associations of respiratory health effects with dampness and mold in homes. Indoor Air. 2007. 17:284–296.

34. Douwes J, van Strien R, Doekes G, Smit J, Kerkhof M, Gerritsen J, Postma D, de Jongste J, Travier N, Brunekreef B. Does early indoor microbial exposure reduce the risk of asthma? The Prevention and Incidence of Asthma and Mite Allergy birth cohort study. J Allergy Clin Immunol. 2006. 117:1067–1073.